AIM: To investigate the features of retinal peripheral defocus and its associated variables in unilateral myopia. METHODS: This cross-sectional study included consecutive anisometropic myopic patients who visited Center for Optometry and Visual Science from August 2023 to March 2025 in Guangxi Zhuang Autonomous Region. Eyes were classified based on spherical equivalent(SE)and uncorrected visual acuity(UCVA): myopic eyes(SE ≤-0.50 D, UCVA <0.2 LogMAR)and contralateral normal eyes(SE ≥-0.25, UCVA ≥0 LogMAR). Total relative defocus value(TRDV)across the visual field, RDV at 15°, 30°, and 45°(RDV-15, RDV-30, RDV-45), and quadrant-specific RDV(superior/RDV-S, inferior/RDV-I, temporal/RDV-T, nasal/RDV-N)were compared between groups.RESULTS: This study enrolled 81 anisometropic patients(81 myopic eyes, 81 contralateral normal eyes). The cohort comprised 42 males and 39 females, 47 patients aged 8-12 y and 34 patients aged 13-17 y(mean age: 11.8±2.4 y). Myopic eyes demonstrated significantly higher values in TRDV, RDV-30, RDV-45, RDV-I, RDV-S, RDV-N, and RDV-T versus contralateral normal eyes(all P<0.001). RDV-15 showed no significant difference between groups in either 8-12-year-olds or 13-17-year-olds(both P>0.05). Among 13-17-year-olds, RDV-S also exhibited no intergroup difference(P>0.05). All other parameters differed significantly across both age strata(all P<0.05). In myopic eyes, age positively correlated with TRDV(r=0.31, P=0.005), RDV-30(r=0.33, P=0.002), RDV-45(r=0.32, P=0.004), and RDV-N(r=0.37, P<0.001). In contralateral eyes, scotopic pupil diameter negatively correlated with TRDV(r=-0.25, P=0.03), RDV-45(r=-0.25, P=0.02), RDV-S(r=-0.29, P=0.008), and RDV-N(r=-0.27, P=0.014). And age positively correlated with RDV-N(r=0.30, P= 0.006), axial length positively correlated with RDV-T(r=0.30, P=0.006). CONCLUSION: The peripheral defocus of unilateral myopic eyes varies from that of their contralateral normal counterparts. The former presents hyperopic defocus, which augments with age, while the latter displays myopic defocus, which accentuates with the increase of the scotopic pupil size.

AIM: To investigate the effect of accommodation on peripheral refraction in patients with myopia.METHODS: Cross-sectional study. A total of 105 patients(105 eyes)with myopia were consecutively recruited in this study. According to the degree of myopia, patients were divided into high myopia(SE≤-6.00 D), moderate myopia(-6.00 D0.017).CONCLUSION: The accommodation can affect the peripheral defocus in myopic patients, and the effect on moderate and low myopia is greater than that of high myopia.

Drug-drug interaction (DDI) refers to the interaction between two or more drugs in the body, altering their efficacy or pharmacokinetics. Fully considering and accurately predicting DDI has become an indispensable part of ensuring safe medication for patients. In recent years, many deep learning-based methods have been proposed to predict DDI. However, most existing computational models tend to oversimplify the fusion of drug structural and topological information, often relying on methods such as splicing or weighted summation, which fail to adequately capture the potential complementarity between structural and topological features. This loss of information may lead to models that do not fully leverage these features, thus limiting their performance in DDI prediction. To address these challenges, we propose a relation-aware cross adversarial network for predicting DDI, named RCAN-DDI, which combines a relationship-aware structure feature learning module and a topological feature learning module based on DDI networks to capture multimodal features of drugs. To explore the correlations and complementarities among different information sources, the cross-adversarial network is introduced to fully integrate features from various modalities, enhancing the predictive performance of the model. The experimental results demonstrate that the RCAN-DDI method outperforms other methods. Even in cases of labelled DDI scarcity, the method exhibits good robustness in the DDI prediction task. Furthermore, the effectiveness of the cross-adversarial module is validated through ablation experiments, demonstrating its superiority in learning multimodal complementary information.

Objective To evaluate the accuracy of simplified postnatal growth and retinopathy of prematurity(G-ROP)screening criteria in detecting severe retinopathy of prematurity(ROP)and compare it with the current screening cri-teria and the recommended screening criteria in this study.Methods A total of 1 286 premature infants screened for ROP at Sichuan Provincial People's Hospital from January 2015 to December 2022 were retrospectively selected.All patients under-went routine fundus examination using the binocular indirect ophthalmoscope or wide-angle digital pediatric retinal imaging system(Retcam)after pupil dilation.Detailed clinical data,such as birth weight(BW),gestational age(GA),gender,and fundus examination results,were collected.Fundus lesions were diagnosed and treated according to the Chinese Guidelines for Screening Retinopathy of Prematurity(2014)(the screening criteria were BW＜2 000 g or GA＜32 weeks).The simplified G-ROP screening criteria were defined as BW＜1 051 g or GA＜28 weeks.The recommended screening criteria were defined as BW≤1 500 g or GA≤30 weeks.The performance of screening criteria for detecting severe ROP was analyzed using the receiv-er operating characteristic(ROC)curve.Results A total of 302 infants(23.5％,302/1 286)met the simplified G-ROP screening criteria,of which 159(52.6％,159/302)had severe ROP.A total of 134 infants(45.7％,134/293)with severe ROP were misdiagnosed.The ROC analysis results showed that the sensitivity and specificity of the simplified G-ROP screening cri-teria for detecting severe ROP were 37.54％and 88.52％,respectively,with an area under the curve(AUC)of 0.630.The sensitivity and specificity for detecting severe ROP according to the Chinese Guidelines for Screening Retinopathy of Prematu-rity(2014)were 98.9％and 18.4％,respectively,with an AUC of 0.587.The sensitivity and specificity for detecting severe ROP according to the recommended screening criteria were 91.8％and 47.0％,respectively,with an AUC of 0.694.The rec-ommended screening criteria had reduced the number of screened infants by 380(29.5％,380/1 286)compared to the Chi-nese Guidelines for Screening Retinopathy of Prematurity(2014),and only 7(2.4％,7/293)with severe ROP were misdiag-nosed.Conclusion The simplified G-ROP screening criteria have poor accuracy in detecting severe ROP.Adjusting the cri-teria to BW≤1 500 g or GA ≤30 weeks is more suitable for the screening strategy of ROP in China.

OBJECTIVES: Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset. METHODS: This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score. RESULTS: The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism. CONCLUSIONS PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.
Humans ; Stress Disorders, Post-Traumatic/diagnosis* ; Firefighters/psychology* ; Cross-Sectional Studies ; Algorithms ; Machine Learning

Objective:To explore the pathogenesis and prognostic factors of brain metastasis of hepatocellular carcinoma(HCC)after liver transplantation(LT).Methods:Retrospective review was performed for 17 HCC cases with brain metastasis after liver transplantation from 2000 to 2020.All cases were diagnosed as hepatitis B cirrhosis complicated with HCC.All of them were beyond the Milan Criteria.The immunosuppressive regimen consisted of baliximab + mycophenolate mofetil + calcineurin inhibitors(CNIs)+ corticosteroids in early postoperative period with a gradual tapering of corticosteroids and mycophenolate mofetil.Three patients received sirolimus immunotherapy after tumor recurrence and withdrew CNIs.One of three cases received sorafenib.Results:Other organ involvements included lung metastasis( n=16, 94.1%), bone metastasis( n=5, 29.4%)and liver metastasis( n=6, 35.3%). The median survival time after brain metastasis was 7 months and the 1-year cumulative survival rate 29.4%.The median survival time post-LT was 14 months and the 1-year cumulative survival rate 64.7%.Among 7 patients with a resection of brain metastasis, two deaths at Month 1 post-operation were due to cerebral hemorrhage.The longest survival time was 214 months and the median survival time 9 months. Conclusions:The prognosis of brain metastasis post-LT remains poor.However, early detection and reasonable treatment can prolong patient survival time and even achieve long-term survival.Most brain metastases are accompanied by lung metastases.And the finding of lung metastatic tumor hints at a presence of intracranial lesions.

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, of which the pathogenesis is complex and the mortality rate is high. However, current basic research is facing the dilemma of high heterogeneity and difficult translation to clinical practice. In-depth basic research is one of the most important ways to break through the "bottleneck" of clinical diagnosis and treatment of sepsis. The purpose of this review is to analyze the current progress and challenges in the field of basic research on sepsis, and look forward to the potential research directions in the future. Cell function, energy metabolism, microbiota, epigenetics and recovery period of sepsis may be the research priorities.

Sepsis is defined as life-threatening organ dysfunction secondary to a dysregulated host response to infection.It is considered a major cause of death and health loss worldwide.Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021, released in October 2021, included 93 total statements, which addressed screening and initial resuscitation, infection, hemodynamics, ventilation, additional therapies, and goals of care and long-term outcomes.This review interpreted the content ofthe guidelines and also analyzed the underlying issues.The guidelines provide a more accurate framework and guidance for the diagnosis and treatment of sepsis, and may also provide an opportunity to urge researchers in the field of sepsis worldwide to implement further individualized research.

Objective:To evaluate the relationship between perioperative cardiovascular events and serum transient receptor potential vanilloid 1 (TRPV1), calcitonin gene-related peptide (CGRP) and substance P (SP) concentrations in the patients with diabetic peripheral neuropathy (DPN).Methods:Twenty-eight patients with type 2 diabetes mellitus (DM) complicated by DPN undergoing elective non-cardiovascular surgery under general anesthesia, were enrolled in DPN group, and 28 patients with type 2 DM without DPN were included in DM group.Another 28 nondiabetic patients undergoing non-cardiovascular elective surgery under general anesthesia were selected as control group (C group). The patients were 55 to 81 years old and classified as American Society of Anesthesiologists physical status Ⅱ or Ⅲ, regardless of gender.The development of cardiovascular events during surgery and within 24 h after surgery and use of vasoactive drugs were recorded.Venous blood samples were taken at 30 min before anesthesia induction and 24 h after surgery for determination of the concentrations of TRPV1, CGRP, SP and cardiac troponin I (cTnI) in serum using enzyme-linked immunosorbent assay.Results:Compared with group C, the incidence of perioperative cardiovascular events and utilization rate of vasoactive drugs were significantly increased, the preoperative concentrations of serum TRPV1, CGRP and SP were decreased, and the postoperative concentration of serum cTnI was increased in DM and DPN groups ( P<0.05). Compared with DM group, the incidence of perioperative cardiovascular events was significantly increased, the preoperative concentrations of serum TRPV1, CGRP and SP were decreased, the postoperative concentration of serum cTnI was increased ( P<0.05), and no significant change was found in the utilization rate of vasoactive drugs in DPN group ( P>0.05). The postoperative cTnI concentrations in serum were negatively correlated with the preoperative TRPV1, CGRP and SP concentrations in serum in DPN group ( P<0.01). Conclusion:The increased risk of perioperative cardiovascular events may be related to the decrease in serum TRPV1, CGRP and SP concentrations in DPN patients.

Objective:To determine the relationship between transient receptor potential vanilloid 1 (TRPV1) gene polymorphism and genetic susceptibility to type 2 diabetes mellitus (DM) and intraoperative adverse cardiovascular events (ACVEs).Methods:Eighty-six DM patients and 78 non-DM patients (nDM) undergoing elective knee replacement or posterior lumbar interbody fusion were selected in this study.Real-time fluorescence quantitative polymerase chain reaction was carried out to genotype the rs222747 variant of TRPV1 gene.The ACVEs occurred were recorded during operation, and the risk factors for ACVE developed during operation were identified.Results:Compared with nDM group, the TRPV1 genotype G/G ratio, allele G frequency, and incidence of intraoperative ACVE were significantly increased in DM group ( P<0.05). Aging and TRPV1 genotype GG combined with DM were the risk factors for intraoperative ACVEs occurred ( P<0.05). Conclusion:TRPV1 gene polymorphism is related to the genetic susceptibility to type 2 DM and occurrence of intraoperative ACVEs.